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Why?
The Centers for Disease Control and Prevention on Thursday recommended that children ages 5 to 11 get a third dose of the Pfizer-BioNTech coronavirus vaccine to boost their immunity as cases and hospitalizations rise in many parts of the United States .
CDC Director Rochelle Walensky gave the green light to the recommendation Thursday night, and she has also encouraged parents of children in this age group who have not yet been vaccinated to get their first vaccine soon.
“Vaccination with a primary series in this age group has lagged behind other age groups, leaving them vulnerable to serious disease,” Walensky said. “With over 18 million doses administered in this age group, we know these vaccines are safe and we must continue to increase the number of children protected.”
Walensky also announced that the CDC is reiterating its recommendation that people age 50 and older should get a second booster shot — in most cases a fourth shot — to be considered up to date with their coronavirus immunizations. Previously, the agency said older adults may receive a booster shot. Immunocompromised people aged 12 and over should also get a second booster, she added.
“As cases increase, it’s important that all people have the protection they need,” Walensky added.
The CDC advisors voted 11-1, with one member abstaining, to recommend that 5- to 11-year-olds receive a third dose of the Pfizer vaccine at least five months after completing their first two-shot series should. Children in this age group who are moderately to severely immunocompromised were already eligible to receive a three-dose primary series; High-risk individuals can now receive a fourth booster dose. Eligible children can receive a booster shot immediately.
The guidance comes for a cohort for whom the protection of the two-shot regime has been disappointing. Real studies have shown that the effectiveness of the vaccine in children from 5 to 11 years old quickly declined, although it withstood severe consequences. Data from Pfizer and BioNTech have shown that a booster boosts children’s immune defenses, particularly against the Omicron variant.
The consultants debated whether the CDC offers guidance that children “can” or “should” have a third dose of the booster. The most popular statement “should” in part to align with recommendations for teens and adults.
“What we really need to do is be consistent and be as clear and simple as possible,” said Beth Bell, clinical professor in the University of Washington School of Public Health.
Others supported the booster dose recommendation, as the data shows that a three-dose vaccine is likely to provide greater protection than a two-dose regimen.
“I worry that ‘may’ doesn’t reflect the overall urgency we have with vaccines,” Katherine A. Poehling, professor of pediatrics and epidemiology at Wake Forest School of Medicine.
Helen Keipp Talbot, associate professor of medicine at Vanderbilt University, emphasized that immunocompromised children should receive a fourth shot to boost their immunity, but said the focus should be on getting more otherwise healthy children vaccinated with their primary series.
“Very few got their first two doses and I think it’s incredibly important that we focus on that before we start the booster,” Talbot said.
Vaccine uptake among children aged 5 to 11 is low and it is unclear how many parents will accept booster shots for their children. According to data released by the CDC, fewer than 30 percent of children ages 5 to 11 were fully vaccinated, and about 36 percent had at least one dose of vaccine.
Tracking of the coronavirus vaccine
The Food and Drug Administration on Monday approved a third dose for children ages 5 to 11. The Pfizer vaccine is the only one approved for children in this age group, although the FDA is considering approving other pediatric vaccines in the future.
In a statement released Tuesday, FDA Commissioner Robert M. Califf said that while Covid-19 has been less severe in children than in adults, “the Omicron surge has seen more children contracting the disease and being hospitalized and children may also experience longer-lasting effects, even after initially mild illness.” Califf said the booster was authorized to provide additional protection for children.
The country’s largest association of doctors endorsed the new children’s booster policy, expressing concern that so few children have been vaccinated, partly because of a belief that children do not get as sick from the virus as adults.
“The Omicron variant brought with it changes designed to change that calculus,” Gerald E. Harmon, president of the American Medical Association, said in a statement. “According to the [CDC]Not only did the highly transmissible variant send more children to the hospital and intensive care unit than previous waves, but unvaccinated children were hospitalized twice as often as vaccinated ones.”
Other advisors supported the recommendation of booster shots for all children in this age group to simplify CDC advice and to protect immunocompromised and otherwise vulnerable children who may be exposed to healthy children in school or other settings.
“It’s confusing when we say ‘may,'” said Camille Nelson Kotton, an associate professor of medicine at Harvard Medical School who treats transplant patients. “I am very surprised to find that the vast majority of immunocompromised patients are not up to date with their vaccines and are susceptible to significant, including life-threatening, infections. I believe that a “should” recommendation would help provide the needed clarity.”
While children are generally more easily ill than adults, some are at risk of serious illness from Covid-19. Since vaccines for children were approved in November, there have been 2.9 million coronavirus cases, 6,700 hospitalizations, 739 cases of childhood multisystem inflammatory syndrome (MIS-C) and 95 deaths in children aged 5 to 11, according to the data presented years Thursday. The vast majority of these hospitalized children – 90 percent – were unvaccinated. And 93 percent of the children who developed MIS-C were unvaccinated.
Federal health data released in April showed that by the end of February, 3 in 4 children in the US had contracted the coronavirus at least once since the pandemic began.
The CDC advisors reviewed data showing the potential of the booster shot to prevent infection and the likelihood that the third dose could reduce the risk of post-Covid conditions like MIS-C, which affect children ages 5 to 11 According to data presented, most likely to suffer Thursday. Two studies of coronavirus in adolescents found that vaccinated people were less likely to develop post-Covid illness and less likely to experience symptoms 12 to 20 weeks after infection compared to unvaccinated people.
In a clinical study that looked at the safety of the booster dose, no serious adverse events were reported among participants, including no deaths or cases of anaphylaxis after the third vaccination. The most common symptoms following the injection were all mild and included pain, redness and swelling at the injection site, and fatigue.
Children aged 5 to 11 are the last age group to have access to a booster shot. The CDC recommended booster shots for children ages 12 to 17 in January and for all adults in November. The agency allowed people age 65 and older to have a second booster dose — in most cases a fourth — although it didn’t recommend the additional booster shot for these older adults. The nation’s youngest children, under the age of 5, do not yet have an approved vaccine.
The advisors’ advice comes amid concerns about waning immunity to vaccines and past infections, while a highly transmissible subvariant of Omicron called BA.2 is rapidly becoming dominant in the United States. The nation hit 1 million coronavirus deaths this week.
“There are too many who do not have the protections they need as we face a continued increase in cases and hospitalizations,” CDC Director Rochelle Walensky said during Thursday’s meeting. “We know that immunity wanes over time and we must do what we can now to protect those who are vulnerable.”
New infections hit nearly 100,000 nationwide this week, raising concerns the nation could see another spike as people plan to gather for Memorial Day weekend. Biden officials who have appealed to Congress to authorize more Covid standby funding earlier this month warned of a possible summer wave in the South and a fall wave that could infect 100 million people.